When used in specific diseases and conditions, medical ozone produces the same or similar therapy results worldwide. Improper application in the form of erratic methods and doses is the most frequent cause of ineffectiveness and adverse effects - and always the cause of violent controversies.

For this reason, the medical societies for ozone application have set up treatment protocols as basis for standards and guidelines, revised and published as a result of the most recent research and 30 years of experience (Beck, Wasser, Viebahn 1998; Knoch, Viebahn 2009; Viebahn, León, Fahmy 2012). They are here made full use of in the standardization of applications, indications, concentrations, doses and frequency of treatment as based on the mechanism of action and the pharmacology of ozone.

1. In its pharmacological effect, medical ozone follows the principle of hormesis: low concentrations (or doses) show a high efficacy, which decreases with increasing concentration, finally reversing into a questionable and even toxic effect.
Concentrations for the systemic application of ozone - in the form of a standardized major ozone autohemotherapy and rectal ozone gas insufflation: 10 – 40 µg ozone / ml ozone/oxygen mixture represent those levels which are physiologically effective and recommended for systemic application.
In the high concentration range of 60-100 µg/ml, the antibiotic effect of ozone has a wide range of applications in the treatment of infected wounds, diabetic foot, decubitus ulcers and burns, but completely restricted to the topical forms of application.

Chronic oxidative stress (pathologically increased values for malone dialdehyde MDA, hydrogen peroxide H2O2, total hydroperoxide TH etc.) and an antioxidant deficit (disbalanced superoxide dismutase and subgroups of SOD as well as catalase CAT and others) are phenomena common to all the above diseases. It is here in particular that low-dose ozone as a hormetic substance, shows a regulatory effect on pathological processes.